Atypical antipsychotics: are some more atypical than others?
Atypical antipsychotics: are some more atypical than others?
复制标题
非典型抗精神病药物：是否有些药物比其他药物更非典型？
作者：
G. Remington;S. Kapur
继氯氮平之后，我们现在又有了一些新的药物（利培酮、奥氮平、喹硫平、舍替多尔和齐拉西酮）。它们都是一样的吗？有什么不同？我们如何才能最好地理解它们？在本文中，我们回顾了目前的临床证据，比较了这些问题的四种非典型性指标：EPS、催乳素升高、对难治性/阳性症状的优越疗效和对阴性症状的疗效。除利培酮外，所有较新的药物对EPS均有较好的疗效，可避免催乳素升高。氯氮平在难治性精神分裂症中显示出最令人信服的疗效，尽管关于利培酮在这方面的益处的比较数据也在出现。然而，对于反应性患者的阳性症状，是否有哪一种药物比传统抗精神病药物产生更大的效果尚不清楚。氯氮平和奥氮平都显示出对阴性症状的优越疗效，尽管这是对原发性症状还是继发性症状的影响仍存在争议。“非典型性”的确切药理学机制尚不清楚，但强调了几个概念框架，这些概念框架具有这些新药物的特征，并可能区分这些新药物。
Abstract On the heels of clozapine, we now have a number of newer agents (risperidone, olanzapine, quetiapine, sertindole, and ziprasidone). Are they all the same? What are the differences? How do we best understand them? In this article we review current clinical evidence to compare these issues on four measures of atypicality: EPS, prolactin elevation, superior efficacy in refractory/positive symptoms and efficacy against negative symptoms. All the newer agents are superior on EPS and, with the exception of risperidone, avoid prolactin elevation. Clozapine shows the most convincing efficacy in refractory schizophrenia, although comparative data concerning risperidone’s benefit in this respect are also emerging. It is unclear, however, whether any of the agents produce a greater effect than conventional antipsychotics against positive symptoms in responsive patients. Both clozapine and olanzapine have demonstrated superior efficacy against negative symptoms, although it remains controversial whether this is an effect on primary or secondary symptoms. The precise pharmacologic mechanisms underlying ”atypicality” remain unclear, but several conceptual frameworks are highlighted that characterize, and perhaps differentiate, these newer agents.
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影响因子：
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作者：
Jan Volavka;Thomas B. Cooper;P. Czobor;Morris Meisner
通讯作者：
Jan Volavka;Thomas B. Cooper;P. Czobor;Morris Meisner
DOI：
10.1176/ajp.145.5.578
发表时间：
1988-05
期刊：
The American journal of psychiatry
影响因子：
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作者：
W. Carpenter;D. Heinrichs;A. Wagman
通讯作者：
W. Carpenter;D. Heinrichs;A. Wagman
影响因子：
--
作者：
J. Kane;G. Honigfeld;J. Singer;H. Meltzer
通讯作者：
J. Kane;G. Honigfeld;J. Singer;H. Meltzer
精神抑制药剂量和血浆水平在精神病药物治疗中的意义。
影响因子：
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作者：
Baldessarini,RJ;Cohen,BM;Teicher,MH
通讯作者：
Teicher,MH
氯氮平对门诊精神分裂症患者阳性和阴性症状的影响。
DOI：
10.1176/ajp.151.1.20
发表时间：
1994
期刊：
The American journal of psychiatry
影响因子：
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作者：
Breier,A;Buchanan,RW;Kirkpatrick,B;Davis,OR;Irish,D;Summerfelt,A;CarpenterJr,WT
通讯作者：
CarpenterJr,WT